EASD1 suggests the spread of Type 2 diabetes is so rapid that it is approaching epidemic levels. To supply adequate care to those with diabetes, and educate populations about prevention of the disease, quantifying the presence of diabetes in different populations is crucial.
Diabetes is a serious illness with multiple complications and premature mortality, accounting for at least 10% of total health care expenditure in many countries. Complex methods have been developed for estimating cause-specific mortality for some conditions (AIDS, tuberculosis) but not for diabetes. Based on routine statistics, recent WHO reports estimated mortality from diabetes in the world as 987,000 deaths for the year 2002, which was 1.7% of total world mortality. Mortality attributable to diabetes may actually be much higher, because individuals with diabetes most often die of cardiovascular and renal disease.
The rapid increase of diabetes worldwide is primarily a consequence of population growth, population aging, urbanization, and the increasing prevalence of obesity and physical inactivity. Many efforts have been made to explain the causes of Type 2 diabetes. While the pathogenesis of this disease is still not completely understood, it is known that both genetic susceptibility and environmental influences play a role. Diabetes has become a major health problem in many developed countries, and in developing countries the prevalence of Type 2 diabetes has increased significantly in recent years. In China, the prevalence has almost tripled within the last 15 years, from 1% to about 3%.
An urbanized, more sedentary lifestyle and unhealthy diet are thought to contribute greatly to the increase in diabetes and obesity in all ethnic groups. For example, around 90% of all Singaporeans live in high rise government or private apartments. An efficient public transportation system, as well as a policy of decentralizing schools, markets and services to local neighborhoods, means that people walk less and climb fewer steps. The government has made it a point to provide exercise facilities in every neighborhood, but 54.7% of respondents in the National Health Survey of 1998 reported no exercise participation. (Lee)
The WHO estimates that the prevalence of diabetes for all age groups world-wide will increase from 2.8% to 4.4% by 2030. Currently, more men suffer from diabetes than do women, however by 2030 this trend is predicted to reverse. It is also thought that urban populations in developing countries will experience an increased rate of prevalence compared to rural populations. Urbanization is used as a measure of increased risk factors which are assumed to be more prevalent in urban areas compared to urban areas. These factors are diet, obesity, decreased physical activity, and secondary factors such as stress. The most important predicted demographic change is the increase in prevalence among those under 65 years of age.
The global burden of diabetes will more than double over the next 25 years, to reach a total of 366 million by 2030. Most of this increase will occur as a result of a 150% rise in developing countries. Projections of the number of people with diabetes in 2030 take into account the fact that there will be more people in the world and that there will